Et tu Mr Khaw

Et tu Mr Khaw?

 

Sometimes I feel really sorry for Tin Pei Ling.

 

Tin Pei Ling was supposed to have been a sign that thePAPhas finally heard the cries of the young. She was supposed to be a star catch – a pap candidate that shows thatPAPis ready to be hip and happening and not just remain old and fuddy duddy. They could not have done it worse.

 

I do not blame Ms Tin alone though. ThePAPand its unlimited budget had failed badly in its pr management and marketing strategies. Ms Tin became the poster girl for much scorn and derision. Choosing her confirmed for most Singaporeans thatPAPreally did not know the electorate well.

 

This was clear way before nomination day. PM himself made mention of Ms Tin at an NUS forum with the students. He laughingly asked for people to give her and her youth a chance. Just a few days ago, he pledged not to parachute people in at the last minute. Regrets? A little late, dear PM. Now we are beginning to doubt the ability of the PAP to select and attract able candidates.

 

Frankly, I cannot imagine that the PAP selected a totally empty vessel. However, impressions once formed are very difficult to correct. The question is, could these poor impressions have been prevented? Exactly what made Ms Tin become so unpopular?

 

• Kawaii post with Kate Spade bag
• Stamping of feet, and cutesy tantrum, professing “I don’t know what to say on national television
• A deepest regret statement that was extremely shallow – “I did not bring my parents to universal studios”. This was made worse by a younger Nicole Seah’s statement that she was too young to have anything that could be categorized as “deepest” regret”
• She did not think any policies needed to be changed for they were all good.
• Her cooling off day fiasco for which she blamed her assistant but made no apologies for the highly sarcastic and uncalled for content. It did not matter who wrote the comment, as the owner of that site, she should have apologized for such a derogatory comment – that would show class.

 

The above showed a shallow person who is totally supportive of thePAP, who is not likely to make any attempt to speak up against any party policy. The question is, how could thePAPpr team allow such an image to be portrayed to the public? The problem I feel lies more with the attitude the ruling party, than the actual ability of Ms Tin. Did they think the electorate will just accept anyone just because the PAP had selected her? Why was she not prepared for her first public appearance?

 

This is made worse by the feeble attempts at damage control. Every month or other, there would appear an article devoted to Ms Tin in the mainstream media. Instead of reducing public ire, these articles only serve to remind the electorate how we had been forced to “give her a chance” just because she was a member of a GRC team. It takes time for a rookie to show her performance, and if there were no flashes of brilliance, does bringing her name forward really help her popularity?

 

In fact, currently, her trying to keep a low profile, quietly serving her community has put her in a better stead. She has been sabotaged enough by her own. Though, to be fair to her team, she has also made some boo – boos all on her own. Classic case was the statement she made about how all of us will grow older, but some will grow old faster than others. Sigh, Ms Tin, every body grows older at the same rate – one year at a time.

 

Then comes Mr Khaw. He told a wonderful story of how Ms Tin’s grandmother fiercely defended thePAPand Lee Kuan Yew when some people made unfair comments that showed a lack of gratitude for what the party and the former Min Mentor had done.

 

Et tu Mr Khaw? Has she not been sabo-ed enough? Do you really think a story like this will endear?

 

All it tells us is that loyalty to the party will reap rewards to the third generation. Come on. Do we want die hardPAPfans, or do we want loyal Singaporeans with a clear eye to see what is not working, and an ear on the ground to hear the complaints without always pointing to past successes as evidence of present capabilities. And why mention Tin Pei Ling at all. I know there are many die hardPAPsupporters who do the same thing. Talk about THEM – let them feel you appreciate them.

 

Ms Tin, no matter how capable she is will find going forward extremely difficult. Mr Khaw’s statement is more damaging than helpful. Her marriage to the Principal Secretary of the PM already made the public scoff and cry out, “cronyism.” This eg that Mr Khaw cited gave further “proof” for those who love to hate Ms Tin.

 

Some people I know who are kind and gracious tell me that we should give her a chance. Frankly, I do not think the answer is really whether she is given a chance or not.

 

I know that even within the party, she is an embarrassment. I know that pro-opposition Singaporeans want to see her fail. Hence I feel sorry for her. BUT – she is paid too much for sympathy to stick.Singaporewas forced to give her chance, and the protests shout their displeasure at this.

 

Frankly, if I were Ms Tin, I will quietly serve my community, and keep as low a profile as possible. If I were Ms Tin, I will not stand for the next elections – no matter how good I am with the grassroots or how much I love serving the residents of my community.

 

If she is really sincere in wanting to serve the community, she will do better as a social worker and get the pay that these get. With a high flying husband, lack of salary should not cause too much pain. It will give her more credibility. Brush up on understanding why Singaporeans are unhappy and what are the policies that are failing. Come back again when she is more mature, if politics is really her game. Otherwise stay a social worker – there is a desperate need for them.

 

 

 

 

The Price of Life

This is part 2 of what i submitted to public house

 

The Price of Life – Part 2

 

More than ten years ago, someone I knew was diagnosed with cancer. Since the family was fairly well-to-do, she sought treatment from a private hospital. Several hundred thousand dollars later, she passed away. Her husband was devastated. Not long after, he complained of feeling unwell. A battery of tests were ran on him but doctors were still perplexed. They could not find the reason for his illness. While still in hospital, while still being tested, he passed away. His bill – several hundred thousand dollars. This couple owned a house in a fairly good location. The valuation of the house just about covered the bills. Thankfully, his children did not need to get into debt in order to pay the hospital bills. The irony in this story is that while not mentioned in his will, the biggest beneficiary of his estate was the healthcare industry. He, and countless like him, has made it possible for the industry to remain profitable.  No wonder health related shares are the darlings of the stock market, in good times or bad.

 

Was the treatment worth it? I have been reminded again and again of the importance of the economy to the country. So while I cannot do it for others, in order to help my children take a prudent decision, perhaps it is time for me to look at how much my remaining days are worth.

 

For a start, I did not work for much of my life. Family and children have always been far more important to me than career. So as a rough estimate, and spreading it out over the years, I probably earned an average of $15000 a year for the past 25 years. That would mean a lifetime earnings of $450 000, and I am erring on the side of generosity. The choice of staying home also meant we hardly have any savings – after all it is not easy to live on a single income. I have had health challenges for the last 10 years. So while I think I am fit to work, I cannot over-stretch myself. Currently, I hardly work at all, except for piecemeal, freelance work that sometimes come my way. If I want to be generous, let me just assume that the next medical report is a positive one and I can get back to part time work – if I can find a job that is. Say I then can earn $15000 per annum. If I do survive until age 62, I have the capacity to earn another $150 000. Technically, that is all my remaining life is worth – $150 000.

 

So how does it make economical sense for medical costs to be so high? How can $600 pills, thousand – dollar MRI scans, several hundred thousand dollar hospital stays be justified? How can medical costs exceed what some one can earn in a lifetime?

 

Ah, you say, your contribution to the family and to society cannot be pegged on money alone. Your love, your care your prayers are worth much more. In fact they are priceless. I certainly hope that not everything we do out of love has to be valued in monetary terms. I’d like to think that when I am gone, I will be remembered not because of the money or jewellery I leave behind, but for the joy I had given to those who survive me. But let us be practical. While life is priceless, can we afford to live? How have you, as a government, made it possible to sustain life? Or are you paying lip service to the value of my life?

 

Current discussions have been going on and on about how to pay for healthcare. I think before we even begin to consider payment, we should consider the cost. What has made healthcare costs so high?

 

Like many others, I am painfully aware of the importance of health insurance. At several stages of my life, depending on the medication prescribed, I have had to foot $800 or so a month for treatment. Fortunately the cash element has been kept manageable, thanks to the twin contribution from medisave and medishield. Cash element in the bill is NOT the total cost. So when former Minister of Health, Mr Khaw, spoke about $8 heart bypass, that does not tell you how much the operation actually cost. Being able to pay cannot justify the cost.

 

As hospitals are privatized, profits must be generated. Just look at the argumentsSMRTput forth to justify fare increases. Shareholders have to be looked after, and CEO bonuses too. Costs will not come down. If the government load heavy registration costs onto already expensive medication, refuse to subsidise new and improved drugs, cost of medication can only escalate. Medical insurances, including medishield are provided by private insurance companies. A public listed company always aims to generate profits. If medical costs soar, if claims increase, premiums will naturally go up too. If healthcare costs are not controlled, if we continue to pursue profit at every turn, at the same time find what seems to be legitimate reasons to justify a reduction in subsidies, then the day will come when most will not be able to afford insurance even.

 

My husband and I only have one property – an hdb flat. The value of this flat has risen in recent years. It gives me some hope that we can retire and not be a burden to the children, should we downgrade. If we pass on before that time, we hope that the children will have a tiny inheritance each, to help them along this very expensive, difficult world where salaries stagnate and costs soar. We have no intention of contributing to the extremely lucrative healthcare world by making them the beneficiaries of the little we have accumulated through the struggles of our lives. In other words, when push comes to shove, we would opt to cease treatment.

 

To me, the first consideration in healthcare budgeting is not how to pay, but how to reduce cost. To me, it means that as an example, the government cannot look at healthcare from the perspective of how to ensure profitability. Healthcare facilities for the public, like public educational institutions must be seen as cost centres, not profit centres. Furthermore it is time for the government to review how much the life of a citizen is worth, and budget accordingly.

 

It’s time to show us that you are worth what you are paid. Stop telling us the problems. Show us some answers.

 

Hell Care Health Care

This is the unedited post of the article which was published byPublicHouse -http://publichouse.sg/categories/topstory/item/246-the-price-of-life-what-value.

Hell care Health care

 

Well, it certainly feels that way at times. Just recently a bunch of us got into a discussion on healthcare again. Someone in the group shared his personal story. When his father was admitted into a local hospital several years ago, Class C ward-mind you, he was made to sign an undertaking to pay the bill before the staff would proceed with treatment. 5 months of coma later, his dad passed away. His bill – $500 000.

 

This story really got me upset. I do not claim to be an expert on healthcare policies, government budget or hospital administrative policies. I am just an ordinary citizen with healthcare concerns for myself. So do not throw me questions on funding – that is the problem for our superbly well-paid ministers to solve. I am also not going into a discussion on the merits of health insurances and medishield. The discussion will get too involved otherwise.

 

Even as I write this, I hear the many conversations I have had with taxi drivers and the aunties peddling simple ware at the market. “Di zhi dao, ooi si, buay sai pua pi.” Translated from hokkien, what they are saying is, inSingaporeit is ok to die, just don’t get sick.

 

Someone else mentioned that a cancer patient had to pay close to $600 for a pill – that’s right – $600 for ONE pill. Hospital bill so far, $13000. My reply – if I were the patient, I would stop all treatment. That night, I kept wondering if something similar were to happen to me, at what point would I stop treatment? What is the economic value of my remaining life?

 

Yes, this world is so economically driven, so financially based that even life itself must have a price tag. The question is, who determines the price tag?

 

Out of curiosity, I decided to check out the Hippocratic Oath. In particular, I checked out the often used version, rewritten in 1964 by Dr Louis Lasagna (forgive the irreverence – but he sounds almost edible!) One line stood out for me and I quote:

 

“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”

 

How interesting. The medical profession needs to be concerned about how the sickness of the patient affects the financial burden of his family. This seems quite the opposite to what is happening in actuality. Not only does it seem as if an impersonal system is uncaring of the “economic instability” of the family, it seems to want to ensure that the family is responsible for every last coin that the treatment may cost, never mind if it costs more than the family home.

 

I grant you there are those who care, that there is help available – if you know how to look. I know doctors who bring foreign patients into their own homes while they are recuperating from their medical conditions. These would not be able to pay for local accommodation otherwise and once home, would not be able to afford to make trips back toSingaporefor follow-up appointments. I have seen doctors waving their consultation fees when they realize the financial difficulties their patients are in. However, these are the exceptions, not the rule. And as a society, we do not expect the medical staff to be made out of pocket either.

 

After all, we are a meritocratic society, and how good we are is measured by the salary we can command, the amount we can earn. At a recent interview for placement in our prestigious local university, one student who had applied for either law or medicine, I cannot rightly remember which, said this in answer to the question, “Why do you want to be a lawyer/doctor?

“I heard you can earn a lot of money!” It was a cheekily honest answer – and guess what, his honesty paid off – he got a place.

 

I remember how when Ng Eng Hen was introduced, his earnings as a doctor was brandished about as proof of how we had snatched a trophy from the private sector. Currently, doctors, especially specialists are leaving government hospitals in droves. They want to be paid more, for less stress. Let me state emphatically that I do not blame them.

 

What I do blame is how we have allowed ourselves to get to this stage. It begins with a paper chase, and it continues with a paper chase. First it is the degree, then it is the money. What values have we transmitted to our children?

 

During the discussion, someone mentioned the cost of drugs.  Malaysian pharmacies sell drugs at way lower prices thanSingapore. Someone else said that this is because of the low cost of registration of drugs. There is a downside though. Often times, imitation drugs make their way to the counter. These drugs are either ineffective or may pose a danger to the patient. Be that as it may, counterfeit drugs do not make their way to the counter because of lower registration costs. They get there as a result of corruption. There is no reason why we cannot lower the cost here inSingaporeand still maintain a stringent standard of registration. The truth is pharmaceuticals spend a lot of money testing drugs and coming up with new courses of treatment. They want to earn back the money they had spent and then some. As a people, as a government, we cannot control their business policy. However, we can control how much we profit from their successful research. Are we too profit driven?

 

Which brings me to the question I asked earlier -who determines the price tag of my life? In the case of my friend who inherited the $500 000 dollar medical bill, the hospital put the decision squarely on his shoulders by making him sign the undertaking. The value of his father’s life to him was priceless – how else could it be?

 

What if the undertaking was reversed? Instead of making the next of kin sign such an undertaking, bearing in mind the emotional upheavals, the struggles in the conscience on how much filial piety is worth, the lack of medical knowledge that makes such decisions a stab in the dark, why not get the hospital or the government administration to give us a signed policy statement instead? Let them put in black and white to what extent they are willing to treat patients – at which point of debt would they feel compelled to stop treatment. Let them be the one to put a price tag on lives – for they can do so in an impartial, considered and educated manner. The next of kin can still try to maintain treatment by servicing the debt to acceptable levels – if he can find the means to. When he cannot, then let the professionals pull the plug. Stop putting the guilt on the relatives – make the expert decision and take the responsibilities that come with it.

 

I know I sound cynical and upset. I am cynical and upset. I have one last proposal to make. To me it is absurd to expect the common folk to pay hundreds of thousands of dollars in medical bills. I propose that there is a cap set on the cash portion of medical bills. This can be gradated according the financial standing and affordability of the individual patients. Beyond this amount, I feel a specially set up fund must foot the bill.

 

I will conclude by quoting the last two lines of the Hippocratic Oath. My prayer is that as a nation, we can help the medical professionals keep their professions honourable and noble.

 

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.